Cross Institutions Infection Control Audits

_{Shared by Tang Xin Yan, SingHealth Duke-NUS Institute for Patient Safety & Quality (IPSQ), Singapore. GKPS Reference: Cross-institutions Infection Control Audit Tools. Global Knowledge Sharing Platform for Patient Safety (GKPS). 2023. A007.}

The harmonized Cross-Institutions Infection Control (CIIC) Audit Tools are adapted from validated national and international guidelines designed for each audit and refined for practical applications. The audit tools are part of the CIIC collaborative model developed by the SingHealth Duke-NUS Institute for Patient Safety & Quality (IPSQ), to monitor health care hygiene compliance for infection control and to build a safer system for our patients, staff, and visitors.

The model is implemented through a three-pronged approach comprising the audit tools, management and training of auditors, as well as a structured audit process. It has demonstrated to be effective in ensuring a high level of hygiene and safety for the cluster.

The CIIC audits are conducted by a multidisciplinary team of auditors using the harmonized audit tools. The audits serve to assess risks, monitor effectiveness, and promote infection control best practices across the cluster to minimize the occurrence of healthcare-associated infections. The compliance rates, findings and corrective actions for all audits are reported in a timely manner to institution and cluster leadership for oversight.

The five harmonized CIIC Audit Tools are:

(i)     Cross Institution Environmental Hygiene (CIEH) Audit Tool. The focus of the CIEH Audit Tool is on dirt and blood in the environment, equipment and furniture. Processes audited include glucometer maintenance to eliminate blood stains, cleaning of equipment between use, storage of sterile items, accessibility of alcohol-based wipes and hand washing facilities, and knowledge of housekeeping staff on the use of different coloured cloths for cleaning.

(ii)   Cross Institution Hand Hygiene (CIHH) Audit Tool. The CIHH Audit Tool is aligned with the World Health Organization (WHO) Five Moments for Hand Hygiene.

(iii)  Cross Institution Kitchen Hygiene (CIKH) Audit Tool. The CIKH Audit Tool was adopted from the Singapore Ministry of Health (MOH) Infection Prevention and Control (IPC) Audit Tool. The focus is to maintain kitchen hygiene through checks on environment cleanliness, food storage, staff hygiene and cleaning of equipment processes.

(iv)  Cross Institution Endoscopy Reprocessing (CIER) Audit Tool. The CIER Audit Tool was adopted from the MOH IPC Audit Tool, to ensure compliance and hygiene by checking on Endoscopy reprocessing and storage of sterile supplies.

(v)   Cross Institution Sterile Processing (CISP) Audit Tool. The CISP Audit Tool was adopted from the Asia Pacific Society of Infection Control (APSIC) checklist, to ensure compliance and hygiene by checking on sterilisation processes and storage of sterile supplies.